Bacterial Etiological Agents of Lower Respiratory Tract Infection Among HIV/AIDS Patients

Abstract

In Human Immunodeficiency Virus infected patients, bacterial lower respiratory tract infections (LRTI) are the most frequent respiratory diseases. This study was conducted to determine the bacterial etiology of LRTI in HIV/AIDS patients as well as update various antimicrobial alternatives available in the treatment. The study included sputum specimens from patients with or without complaints of LRTI. Gram staining, ZiehlNeelsen staining and sputum culture were performed. Antibiotics resistant pattern was also examined by Kirby-Bauer’s disc diffusion method. Among 121 patients, 39.7% were growth positive whereas 60.3% growth negative. The study showed females had more LRTI (54.3%) than male (51.2%). It also revealed older age group, smoking habit and lower CD4+cell count are the risk factors for LRTI. Similarly, patients under Anti-Retroviral Therapy (ART) had lower LRTI. From 48 cultures positive cases, Gram positive bacteria and Gram negative bacteria were found to be 39.6% and 60.4% respectively. In addition 15.7% of cases had infection with Acid Fast Bacilli (AFB). The present study showed higher prevalence of gram-negative bacteria (60.4%) compared to gram-positive bacteria (39.6%). K. pneumoniae(27.0%)was the most prevalent gram-negative bacteria whereas S. aureus (20.8%) was the most predominant gram-positive bacteria. Antibiotic mostly resisted by Gram positive bacteria was Co-trimoxazole (68.4%) and Penicillin (68.4%) followed by Amoxicillin (47.4%), Chloramphenicol (42.1%), Ciprofloxacin (36.8%), Oxacillin (36.8%) and Azithromycin (31.6%). Likewise, Gram-negative bacteria was found to be mostly resistant to Amoxicillin (79.3%) followed by Co-trimoxazole (62.1%), Gentamycin (62.0%), Ciprofloxacin (55.2%),Ofloxacin (51.7%), Ceftriaxone (51.7%) and Azithromycin (48.3%).